Brainscape's Knowledge GenomeTM

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


See full index

Pathology > Musculoskeletal, Skin, and Connective Tissue > Flashcards

Musculoskeletal, Skin, and Connective Tissue Flashcards

1
Q

Define osteonecrosis (i.e., avascular necrosis)

A

Infarction of bone and marrow, usually very painful.

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

Causes of primary osteoporosis

A
  1. Long-term exogenous steroid use
  2. Anticonvulsants
  3. Anticoagulants
  4. Thyroid replacement therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stages of Paget disease

A
  1. Lytic – osteoclasts
  2. Mixed – osteoclasts + osteoblasts
  3. Sclerotic – osteoblasts
  4. Quiescent – minimal osteoclast/osteoblast activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical findings in Paget disease (osteitis deformans)

A
  1. Hat size can be increased
  2. Hearing loss is common due to auditory foramen narrowing
  3. Increased blood flow through arteriovenous shunts may cause high-output heart failure
  4. Long bone chalk-stick fractures
  5. Increased risk of osteogenic sarcoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lab findings in Paget disease

A
  1. Serum Ca2+ is normal
  2. Serum phosphorus is normal
  3. Serum PTH levels and normal
  4. Serum ALP levels are increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common site of osteonecrosis (avascular necrosis)

A

Femoral head (due to insufficiency of medial circumflex femoral artery)

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

Causes of osteonecrosis (avascular necrosis)

A
  1. Alcoholism
  2. Sickle cell disease
  3. Exogenous/Endogenous corticosteroids
  4. Pancreatitis
  5. Trauma
  6. Idiopathic (Legg-Calve-Perthes disease)
  7. Caisson (“the bends”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lab findings in osteoporosis

A

Serum Ca, PO4, ALP, and PTH are all normal; only abnormal finding is decreased bone mass

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

Lab findings in osteopetrosis

A

Serum PO4, ALP, and PTH are normal; serum Ca may be normal or decreased in severe, malignant disease; bones are dense and brittle

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

Lab findings in Paget disease of bone

A

Serum Ca, PO4, and PTH are normal; serum ALP is increased; bones exhibit abnormal “mosaic” architecture

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

Lab findings in osteomalacia/rickets

A
  1. Serum Ca is decreased
  2. Serum PO4 is decreased
  3. Serum ALP is increased
  4. Serum PTH is increased

Remember: bones are soft in this disease

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

Lab findings in hypervitaminosis D

A
  1. Increased serum Ca
  2. Increased PO4
  3. Normal ALP
  4. Decreased PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of hypervitaminosis D

A
  1. Oversupplementation

2. Granulomatous disease (e.g., sarcoidosis)

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

Lab findings in primary hyperparathyroidism

A
  1. Increased serum Ca
  2. Decreased serum PO4
  3. Increased serum ALP
  4. Increased serum PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is osteitis fibrosa cystica and what causes it?

A

“Brown tumors” due to fibrous replacement of bone and subperiosteal thinning. It is a result of hyperparathyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lab findings in secondary hyperparathyroidism

A
  1. Decreased serum Ca
  2. Increased serum PO4
  3. Increased serum ALP
  4. Increased serum PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Secondary hyperparathyroidism is often a compensatory response to…

A

ESRD (decreased PO4 excretion and decreased production of activated vitamin D)

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

“Soap bubble” appearance of X-ray

A

Giant cell tumor

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

Giant cell tumors are comprised of…and occur at…

A

Multinucleated giant cells; epiphyseal end of long bones

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

Most common benign bone tumor

A

Osteochondroma

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

Osteochondromas are comprised of…

A

Mature bone with cartilaginous (chondroid) cap

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

An osteochondroma is really just an…

A

Exostosis of the bone

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

Most common primary malignant bone tumor

A

Multiple myeloma

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

Predisposing factors for osteosarcoma (osteogenic sarcoma)

A
  1. Paget disease of bone
  2. Bone infarcts
  3. Radiation
  4. Familial retinoblastoma
  5. Li-Fraumeni syndrome (germline p53 mutation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Osteosarcoma most commonly occurs at…

A

Metaphysis of long bones, often around knee

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

Treatment for osteosarcoma

A

Surgical en bloc resection (with limb salvage) and chemotherapy

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

Describe the appearance of an osteosarcoma on X-ray.

A

X-ray reveals a Codman triangle (from elevation of the periosteum) or sunburst pattern

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

Ewing sarcoma is seen in…and commonly appears in…

A

Boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the histologic appearance of Ewing sarcoma.

A

Anaplastic small blue cell malignant tumor with “onion skin” periosteal reaction in bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ewing sarcoma is associated with…translocation, leading to production of fusion protein…

A

t(11,22); EWS-FLI1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Joint findings in osteoarthritis

A
  1. Subchondral cysts
  2. Sclerosis
  3. Osteophytes (bone spurs)
  4. Eburnation (polished, ivory-like appearance of bone)
  5. Synovitis
  6. Heberden nodes (DIP)
  7. Bouchard nodes (PIP)
  8. No MCP involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Classic presentation of osteoarthritis

A
  1. Pain in weight-bearing joints after use (e.g., at the end of the day), improving with rest
  2. Knee cartilage loss begins medially (“bowlegged”)
  3. Noninflammatory
  4. No systemic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment for osteoarthritis

A
  1. Acetaminophen
  2. NSAIDs
  3. Intra-articular glucocorticoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

The inflammatory destruction of synovial joints in rheumatoid arthritis is mediated by…

A

Cytokines and type III and type IV hypersensitivity reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Joint findings in rheumatoid arthritis

A
  1. Pannus (inflammatory granulation tissue) formation in joints (MCP and PIP)
  2. Subcutaneous rheumatoid nodules, which represent fibrinoid necrosis
  3. Ulnar deviation of fingers
  4. Rare swan neck and boutonniere deformities
  5. Rare DIP involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

There is a strong association between the…genotype and rheumatoid arthritis.

A

HLA-DR4

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

80% of pts with RA are positive for…

A

Rheumatoid factor (anti-IgG IgM antibody)

Remember: anti-cyclic citrullinated peptide antibody is more specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Classic presentation of RA

A
  1. Morning stiffness lasting > 30 min and improving with use
  2. Symmetric joint involvement
  3. Systemic symptoms (fever, fatigue, weight loss, pleuritis, pericarditis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment for RA

A
  1. NSAIDs
  2. Glucocorticoids
  3. Disease-modifying agents (methotrexate, sulfasalazine)
  4. Biologics (TNF-alpha inhibitors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Autoimmune disorder characterized by destruction of exocrine glands (especially lacrimal and salivary) by lymphocytic infiltrates.

A

Sjogren syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Clinical findings in Sjogren syndrome

A
  1. Inflammatory joint pain
  2. Xerophthalmia (decreased tear production and subsequent corneal damage)
  3. Xerostomia (decreased saliva production)
  4. Presence of antinuclear antibodies: SS-A (anti-Ro) and/or SS-B (anti-La)
  5. Bilateral parotid enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Complications of Sjogren syndrome

A
  1. Dental caries

2. Mucosa-associated lymphoid tissue (MALT) lymphoma

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

Acute inflammatory monoarthritis caused by precipitation of monsodium irate crystals in joints

A

Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Gout is associated with hyperuricemia, which can be caused by:

A
  1. Underexcretion of uric acid (90% of pts) – largely idiopathic; can be exacerbated by certain meds (e.g., thiazide diuretics)
  2. Overproduction of uric acid (10% of pts) – seen in Lesch-Nyhan syndrome and tumor lysis syndrome (i.e., due to increased cell turnover)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Monosodium urate crystals are…and…under polarized light (yellow under parallel light).

A

Needle shaped; negatively birefringent

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

Symptoms of gout

A
  1. Asymmetric joint distribution
  2. Joint is swollen, red, and painful
  3. Tophus formation – often on external ear, olecranon bursa, or Achilles tendon
  4. Acute attack tends to occur after a large meal or alcohol consumption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Why does alcohol consumption trigger acute attacks of gout?

A

Alcohol metabolites compete for same excretion sites in the kidney as uric acid –> decreased uric acid secretion and subsequent buildup in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Classic manifestation of gout is…

A

Painful MTP joint of big toe (podagra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Treatment of gout

A

Acute: NSAIDs (e.g., indomethacin), glucocorticoids, colchicine
Chronic (preventive): xanthine oxidase inhibitors (e.g., allopurinol, febuxostat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Pseudogout presents with…and is caused by…

A

Pain and effusion in a joint; deposition of calcium pyrophosphate crystals within the joint space (chondrocalcinosis on X-ray)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Calcium pyrophosphate forms…that are…under polarized light.

A

Basophilic, rhomboid crystals; weakly birefringent (blue when parallel to the light)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Pseudogout usually affects…

A

Large joints (classically the knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Diseases associated with pseudogout include…

A
  1. Hemochromatosis
  2. Hyperparathyroidism
  3. Osteoarthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Treatment for pseudogout includes…

A
  1. NSAIDs for sudden, severe attacks
  2. Glucocorticoids
  3. Colchicine for prophylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Common causes of infectious arthritis

A
  1. S. aureus
  2. Streptococcus
  3. Neisseria gonorrhoeae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Gonococcal arthritis presents with…

A
  1. Synovitis (e.g., of the knee)
  2. Tenosynovitis (e.g., of the hand)
  3. Dermatitis (e.g., pustules)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Arthritis without rheumatoid factor (no anti-IgG antibody) and having a strong association with HLA-B27 (gene that codes for an MHC class I molecule) is referred to as…

A

Seronegative spondyloarthropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Classic presentation of psoriatic arthritis

A
  1. Asymmetric and patchy involvement
  2. Dactylitis (“sausage fingers”)
  3. “Pencil-in-cup” deformity on X-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Chronic inflammatory disease of spine and sacroiliac joints

A

Ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Classic presentation of ankylosing spondylitis

A
  1. Ankylosis (stiff spine due to fusion of joints)
  2. Uveitis
  3. Aortic regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Arthritis associated with inflammatory bowel disease presents as…

A

Ankylosing spondylitis or peripheral arthritis associated with Crohn disease or ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Reactive arthritis presents with the classic triad of…

A
  1. Conjunctivitis and anterior uveitis
  2. Urethritis
  3. Arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Reactive arthritis is commonly seen after…

A

GI (Shigella, Salmonella, Yersinia, Campylobacter) or Chlamydia infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Nonbacterial, wart-like vegetations on both sides of heart valve in a pt with SLE

A

Libman-Sacks endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Lupus nephritis is a…hypersensitivity reaction that can present as either a…or…syndrome.

A

Type III; nephritic (diffuse proliferative glomerulonephritis); nephrotic (membranous glomerulonephritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Clinical manifestations of SLE include…

A
  1. Rash (malar or discoid)
  2. Arthritis
  3. Serositis
  4. Hematologic disorders (e.g., cytopenias)
  5. Oral/nasopharyngeal ulcers
  6. Renal disease
  7. Raynaud phenomenon
  8. Photosensitivity
  9. Positive VDRL/RPR test
  10. Antinuclear antibodies
  11. Neurologic disorders (e.g., seizures, psychosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Common causes of death in SLE include…

A
  1. Cardiovascular disease
  2. Infections
  3. Renal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Anti-Smith antibodies in SLE are…

A

Specific, but not prognostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Antihistone antibodies are sensitive for…

A

Detecting drug-induced lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Anti-dsDNA antibodies in SLE are associated with…

A

Poor prognosis (renal disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Antinuclear antibodies are…, but not…for SLE.

A

Sensitive; specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Extensive immune complex formation in SLE leads to…

A

Hypocomplementemia (decreased serum C3, C4, and CH50 levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Treatment for SLE

A
  1. NSAIDs
  2. Steroids
  3. Immunosuppressants
  4. Hydroxychloroquine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Antiphospholipid syndrome is diagnosed based on…

A
  1. Clinical history of thrombosis (arterial or venous) or spontaneous abortion
  2. Lab findings of lupus anticoagulant, anticardiolipin, and anti-beta2 glycoprotein antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Treatment for antiphospholipid syndrome

A

Systemic anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Anticardiolipin antibodies and lupus anticoagulant can cause…and…

A

False-positive VDRL; prolonged PTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Elevated CD4+/CD8+ ratio is characteristic of…

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Sarcoidosis is associated with…

A
  1. Restrictive lung disease (interstitial fibrosis)
  2. Erythema nodosum
  3. Lupus pernio
  4. Bell palsy
  5. Epithelioid granulomas containing microscopic Schaumann and asteroid bodies
  6. Uveitis
  7. Hypercalcemia (due to increased 1-alpha-hydroxylase-mediated vitamin D activation in macrophages)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Treatment for sarcoidosis

A

Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Condition associated with temporal (giant cell) arteritis

A

Polymyalgia rheumatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Symptoms of polymyalgia rheumatica

A

Pain and stiffness in shoulders and hips, often with fever, malaise, and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Lab findings in polymyalgia rheumatica

A

Increased ESR, increased CRP, normal CK

83
Q

Polymyalgia rheumatica exhibits a rapid response to…

A

Treatment with low-dose corticosteroids

84
Q

Chronic, widespread musculoskeletal pain associated with stiffness, paresthesias, poor sleep, fatigue

A

Fibromyalgia

85
Q

How is fibromyalgia treated?

A

With regular exercise, antidepressants (TCAs, SNRIs), and anticonvulsants

86
Q

Metaplasia of skeletal muscle into bone following muscular trauma is known as…

A

Myositis ossificans

87
Q

Myositis ossificans is most often seen in…and may present as…

A

Upper or lower extremity; suspicious “mass” at site of known trauma or as incidental finding on radiography

88
Q

Progressive symmetric proximal muscle weakness characterized by endomysial inflammation with CD8+ T cells

A

Polymyositis

89
Q

Polymyositis most often involves the…

A

Shoulders

90
Q

Similar to polymyositis, but also involves malar rash (similar to SLE), Gottron papules, heliotrope (erythematous periorbital) rash, “shawl and face” rash, and “mechanic’s hands”

A

Dermatomyositis

91
Q

Describe the pathogenesis of dermatomyositis.

A

Perimysial inflammation and atrophy with CD4+ T cells

92
Q

Lab findings in polymyositis/dermatomyositis

A
  1. Increased CK
  2. Positive ANA test
  3. Positive for anti-Jo-1 antibodies
  4. Positive for anti-SRP antibodies
  5. Positive for anti-Mi-2 antibodies
93
Q

Treatment for polymyositis/dermatomyositis

A

Steroids followed by long-term immunosuppressant therapy (e.g., methotrexate)

94
Q

Clinical findings in myasthenia gravis

A

Ptosis, diplopia, muscle weakness, and worsening of symptoms with muscle use

95
Q

Myasthenia gravis is associated with…

A
  1. Thymoma

2. Thymic hyperplasia

96
Q

Clinical findings in Lambert-Eaton myasthenic syndrome

A

Proximal muscle weakness, autonomic symptoms (dry mouth, impotence), and improvement of symptoms with muscle use

97
Q

Lambert-Eaton myasthenic syndrome is associated with…

A

Small cell lung cancer

98
Q

Flat lesion with well-circumscribed change in skin color

A

Macule

99
Q

Macule > 1 cm

A

Patch

100
Q

Elevated solid skin lesion

A

Papule

101
Q

Papule > 1 cm

A

Plaque

102
Q

Small fluid-containing blister

A

Vesicle

103
Q

Large fluid-containing blister > 1 cm

A

Bulla

104
Q

Vesicle containing pus

A

Pustule

105
Q

Transient smooth papule or plaque

A

Wheal

106
Q

Flaking off of stratum corneum

A

Scale

107
Q

Dry exudate

A

Crust

108
Q

Scleroderma (systemic sclerosis) presents with triad of…

A
  1. Autoimmunity
  2. Noninflammatory vasculopathy
  3. Collagen deposition with fibrosis
109
Q

Diffuse scleroderma involves…

A

Widespread skin involvement, rapid progression, and early visceral involvement

110
Q

Anti-Scl-70 (anti-DNA topoisomerase I) antibodies are associated with…

A

Diffuse scleroderma

111
Q

Limited scleroderma involves…

A

Limited skin involvement confined to fingers and face

112
Q

Anti-centromere antibodies are associated with…

A

Limited scleroderma

113
Q

Limited scleroderma commonly presents as CREST syndrome consisting of…

A
  1. Calcinosis
  2. Raynaud phenomenon
  3. Esophageal dysmotility
  4. Sclerodactyly
  5. Telangiectasia
114
Q

Digital (or fingertip) pitting is characteristic of…

A

Scleroderma

115
Q

Death in scleroderma is most often due to…

A

Sclerosis of pulmonary system

116
Q

List the layers of the epidermis from surface to base

A
  1. Stratum corneum (comprised of keratin)
  2. Stratum lucidum
  3. Stratum granulosum
  4. Stratum spinosum (held together by desmosomes)
  5. Stratum basale (stem cell site)
117
Q

Tight junctions (zonula occludens) prevent…and are composed of…

A

Paracellular movement of solutes; claudins and occludins

118
Q

Adherens junctions (zonula adherens) sit below…and form a “belt” connecting…of adjacent cells.

A

Tight junctions; actin cytoskeletons

119
Q

Adherens junctions are made up of…

A

Cadherins (Ca2+-dependent adhesion proteins)

120
Q

Loss of…promotes metastasis

A

E-cadherin expression

121
Q

Desmosomes (macula adherens) provide…by facilitating…between adjacent cells.

A

Structural support; keratin interactions

122
Q

Autoantibodies directed against desmosomes are found in pts with…

A

Pemphigus vulgaris

123
Q

Gap junctions are comprised of channel proteins called…that permit…

A

Connexons; electrical and chemical communication between cells

124
Q

Integrins are membrane proteins that bind to…

A

Collagen and laminin in basement membrane

125
Q

Hemidesmosomes connect…in basal cells to…

A

Keratin; underlying basement membrane

126
Q

Autoantibodies directed against hemidesmosomes are found in pts with…

A

Bullous pemphigoid

127
Q

Increased thickness of the stratum corneum is referred to as…

A

Hyperkeratosis

128
Q

Hyperkeratosis with retention of nuclei in the stratum corneum is referred to as…

A

Parakeratosis (seen in psoriasis)

129
Q

Epidermal accumulation of edematous fluid in intercellular spaces is referred to as…

A

Spongiosis (seen in eczematous dermatitis)

130
Q

Separation of epidermal cells is known as…

A

Acantholysis (seen in pemphigus vulgaris)

131
Q

Epidermal hyperplasia resulting in increased thickness of the stratum spinosum is referred to as…

A

Acanthosis

132
Q

Normal melanocyte number with decreased melanin production due to decreased tyrosinase activity or defective tyrosine transport is seen in…

A

Albinism, which can also be caused by failure of neural crest cell migration during fetal development

133
Q

Hyperpigmentation associated with pregnancy or OCP use is known as…

A

Melasma (chloasma)

134
Q

Autoimmune destruction of melanocytes results in…

A

Vitiligo, which presents as irregular areas of complete depigmentation

135
Q

Obstructive and inflammatory disease of the pilosebaceous unit predominantly found on the face and trunk

A

Acne

136
Q

Pruritic eruption, commonly on skin flexures

A

Atopic dermatitis (eczema)

137
Q

Eczema is often associated with…

A

Asthma and allergic rhinitis

138
Q

Eczema usually starts on…in infancy and appears in…thereafter.

A

Face; antecubital fossae

139
Q

Type IV hypersensitivity reaction that follows exposure to allergen

A

Allergic contact dermatitis

140
Q

Common causes of contact dermatitis include…

A
  1. Nickel
  2. Poison ivy
  3. Neomycin
141
Q

The common mole is referred to medically as a…

A

Melanocytic nevus

142
Q

Intradermal nevi are…, while junctional nevi are…

A

Papular; flat macules

143
Q

Papules and plaques with silvery scaling, especially on knees and elbows are characteristic of…

A

Psoriasis

144
Q

Pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off is known as…

A

Auspitz sign (seen in psoriasis)

145
Q

Psoriasis can be associated with…

A

Nail pitting and psoriatic arthritis

146
Q

Inflammatory facial skin disorder characterized by erythematous papules and pustules, but no comedones.

A

Rosacea

147
Q

Rosacea may be associated with…

A

Facial flushing in response to external stimuli (e.g., alcohol, heat).

148
Q

Chronic inflammatory changes in pts with rosacea may lead to…

A

Rhinophyma (bulbous deformation of the nose)

149
Q

Flat, greasy, pigmented squamous epithelial proliferation with keratin-filled cysts (horn cysts)

A

Seborrheic keratosis

150
Q

Sudden appearance of multiple seborrheic keratoses, indicating an underlying malignancy (e.g., GI, lymphoid)

A

Leser-Trelat sign

151
Q

Soft, tan-colored, cauliflower-like papules caused by HPV

A

Verrucae

152
Q

Pruritic wheals that form after mast cell degranulation

A

Urticaria

153
Q

Very superficial skin infection that exhibits honey-colored crusting

A

Impetigo (usually due to S. aureus or S. pyogenes infection)

154
Q

Acute, painful, spreading infection of deeper dermis and subcutaneous tissues

A

Cellulitis (usually due to S. aureus or S. pyogenes infection)

155
Q

Infection involving upper dermis and superficial lymphatics that presents with well-defined demarcation between infected and normal skin

A

Erysipelas (usually due to S. pyogenes infection)

156
Q

Collection of pus from a walled-off infection within deeper layers of skin

A

Abscess (offending organism is almost always S. aureus)

157
Q

Deeper tissue injury, usually from anaerobic bacteria or S. pyogenes; results in crepitus from methane and CO2 production

A

Necrotizing fasciitis

158
Q

In staphylococcal scalded skin syndrome, exotoxins destroys keratinocyte attachments in…

A

Stratum granulosum only

159
Q

Characterized by fever and generalized erythematous rash with sloughing of the upper layers of the epidermis that heals completely

A

Staphylococcal scalded skin syndrome

160
Q

Umbilicated papules caused by a poxvirus

A

Molluscum contagiosum

161
Q

Presents with multiple crops of lesions in various stages from vesicles to crusts

A

Varicella

162
Q

Irregular, white, painless plaques on tongue that cannot be scraped off

A

Hairy leukoplakia

163
Q

Hairy leukoplakia is mediated by…and occurs in…

A

EBV; HIV-positive pts and organ transplant recipients

164
Q

Potentially fatal autoimmune skin disorder with IgG antibody directed against desmoglein

A

Pemphigus vulgaris

165
Q

Keratinocytes in the stratum spinosum are connected by…

A

Desmosomes

166
Q

Separation of epidermis upon manual stroking of skin

A

+ Nikolsky sign

167
Q

Less severe than pemphigus vulgaris; involves IgG antibody against hemidesmosomes

A

Bullous pemphigoid

168
Q

Unlike bullous pemphigoid, pemphigus vulgaris involves…

A

The oral mucosa.

169
Q

In cases of bullous pemphigoid, immunofluorescence reveals…

A

Linear pattern at epidermal-dermal junction

170
Q

In bullous pemphigoid,…

A

Tense blisters containing eosinophils affect the skin

171
Q

Associated with celiac disease, this skin disorder presents as pruritic papules, vesicles, and bullae (often over the elbows) in which IgA deposits may be found at the tips of dermal papillae

A

Dermatitis herpetiformis

172
Q

Presents with multiple types of lesions – macules, papules, vesicles, and target lesions

A

Erythema multiforme

173
Q

Erythema multiforme is associated with certain…

A
  1. Infections (e.g., Mycoplasma pneumoniae, HSV)
  2. Drugs (e.g., sulfa drugs, beta-lactams, phenytoin)
  3. Cancers
  4. Autoimmune diseases
174
Q

Characterized by fever, bullae formation and necrosis, sloughing of skin, and high mortality rate; typically two mucous membranes are involved and targetoid skin lesions may appear, as seen in erythema multiforme

A

Stevens-Johnson syndrome

175
Q

Stevens-Johnson syndrome is usually associated with…

A

Adverse drug reaction

176
Q

A more severe form of Stevens-Johnson syndrome with >30% of the body surface area involved is called…

A

Toxic epidermal necrolysis

177
Q

Epidermal hyperplasia causing symmetric, hyperpigmented thickening of skin, especially in axilla or on neck

A

Acanthosis nigricans

178
Q

Acanthosis is associated with…

A
  1. Hyperinsulinemia (e.g., diabetes, obesity, Cushing syndrome)
  2. Visceral malignancy (e.g., gastric adenocarcinoma)
179
Q

Premalignant lesions caused by sun exposure that present as small, rough, erythematous or brownish papules or plaques

A

Actinic keratosis

180
Q

Painful inflammatory lesions of subcutaneous fat, usually on anterior shins

A

Erythema nodosum

181
Q

Erythema nodosum is often idiopathic, but can be associated with…

A
  1. Sarcoidosis
  2. Coccidioidomycosis
  3. Histoplasmosis
  4. TB
  5. Streptococcal infections
  6. Leprosy
  7. Crohn disease
182
Q

Pruritic, purple, polygonal planar papules and plaques are the 6 P’s of…

A

Lichen planus

183
Q

When lichen planus affects mucosal surfaces, it manifests as…

A

Wickham striae (reticular white lines)

184
Q

Lichen planus is associated with…

A

Hepatitis C infection

185
Q

Histologically, lichen planus appears as…

A

Sawtooth infiltrate of lymphocytes at dermal-epidermal junction

186
Q

“Herald patch” followed days later by other scaly erythematous plaques, often in a “Christmas tree” distribution, is characteristic of…

A

Pityriasis rosea

187
Q

Pityriasis rosea presents as…

A

Multiple plaques with collarette scale

188
Q

Acute cutaneous inflammatory reaction due to excessive UV irradiation

A

Sunburn

189
Q

Sunburn can lead to…and…

A

Impetigo; skin cancers (basal cell carcinoma, squamous cell carcinoma, melanoma)

190
Q

Most common skin cancer

A

Basal cell carcinoma

191
Q

Histologically, basal cell carcinoma presents as…

A

Pink, pearly nodules, commonly with telangiectasias, rolled borders, central crusting or ulceration

192
Q

Basal cell tumors have…

A

“Palisading” nuclei

193
Q

Second most common skin cancer

A

Squamous cell carcinoma

194
Q

Squamous cell carcinoma of the skin is associated with…

A

Excessive exposure to sunlight, immunosuppression, and occasionally arsenic exposure

195
Q

Squamous cell carcinoma of the skin commonly appears on the…

A

Face, lower lip, ears, and hands.

196
Q

Squamous cell carcinoma presents histologically with…

A

Keratin “pearls”

197
Q

Precursor lesion of squamous cell carcinoma of the skin is…

A

Actinic keratosis

198
Q

Variant of squamous cell carcinoma of the skin that grows rapidly over the course of weeks and may regress spontaneously over the course of months

A

Keratoacanthoma

199
Q

Tumor marker for melanoma

A

S-100

200
Q

List the ABCDEs of melanoma

A
  1. Asymmetry
  2. Border irregularity
  3. Color variation
  4. Diameter > 6 mm
  5. Evolution over time
201
Q

There are at least four different types of melanoma. What are they?

A
  1. Superficial spreading
  2. Nodular
  3. Lentigo maligna
  4. Acral lentiginous
202
Q

Melanomas are often driven by activating mutations in…

A

BRAF kinase

203
Q

Primary treatment for melanoma is…

A

Surgical excision with appropriately wide margins

204
Q

Metastatic or unresectable melanoma in pts with BRAF V600E mutation may benefit from treatment with…

A

Vemurafenib, a BRAF kinase inhibitor

Pathology (8 decks)

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