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MSK Midterm > Pathology > Flashcards

Pathology Flashcards

0
Q

Contact dermatitis

A
  • pruritic, oozing rash with vesicles and edema
  • arises upon exposure to allergens (e.g., poison ivy, nickel, drugs, etc.)
  • treatment: remove allergen, topical glucocorticoids (to reduce inflammatory response)
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1
Q

4 types of hypersensitiviy

A

Type I: allergy (immediate, inflammatory)
Type II: cytotoxic (antibody-mediated)
Type III: Immune complex diseases
Type IV: delayed hypersensitivity, cell-mediated immune memory response (antibody-dependent), contact dermatitis (e.g., poison ivy)

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2
Q

Acne vulgaris

A
  • due to chronic inflamm of hair follicles/sebaceous glands
  • occur either with a hormone-associated increase in sebum production and keratin production, or bc of infection w P. acnes which break down sebum into proinflammatory fatty acids
  • treatment: benzoyl peroxide (antimicrobial) and vitamin A derivatives (to reduce keratin production)
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3
Q

Psoriasis

A
  • Presents as salmon-colored plaques with silver scale
  • tends to erupt on extensor surfaces (knees, elbows, etc), & nails
  • due to excessive keratinocyte proliferation w possible autoimmune etiology (HLA-C gene)
  • Auspitz sign: pin pricks of bleeding when scale is removed from extended dermal papillae
  • Histological features: Acanthosis of the corneum (forms the scale), Parakeratosis (nuclei retention in the stratum corneum), Munro microabcesses (collections of neutrophils in the stratum corneum)
  • treatment: corticosteroids, UV light with psoralen or immune modulating therapy
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4
Q

Lichen Planus

A
  • Pruritic, planar, polygonal purple papules, often w reticular white lines on their surface (Wickham striae)
  • commonly found on wrists, elbows, and oral mucosa
  • associated with hep C virus but exact cause is unknown
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5
Q

Pemphigus Vulgaris

A
  • Autoimmune destruction of desmosomes between keratinocytes (spinosum)
  • IgG antibody against desmoglein (Type II hypersensitivity)
  • Presents as skin and oral mucosa bullae
  • Thin-walled bullae rupture easily (Nikolsky sign); become shallow erosions with dried crust
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6
Q

Palisading is characteristic of what type of skin lesion?

A

Basal cell carcinoma

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7
Q

What are telangiectasis, and what what diagnosis are they associated?

A

They are dilated super epidermal blood vessels, and they are often seen in basal cell carcinomas.

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8
Q

Where do squamous cell carcinomas usually present?

A

On sun exposed surfaces.

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9
Q

What is the ABCDEs of melanoma?

A 
Asymmetry
Border
Color
Diameter
Elevation or Evolution
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10
Q

What are the “seeds” in verruca vulgaris?

A

Verruca vulgaris is the mom on wart, and the “seeds” in the lesions are due to thrombosis capillaries because the warts have out-grown their blood supply.

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11
Q

Define acantholysis.

A

The loss of cell adhesion (e.g., autoimmune targeting desmoglein of desmosomes).

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12
Q

Targetoid skin lesions are characteristic of which skin lesions?

A

Lyme’s disease and erythema multiforme.

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13
Q

Define acanthosis.

A

Thickening of the epidermis via hyperplasia.

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14
Q

What is Auspitz sign, and what is it characteristic of?

A

Pin-sized blood spots when scales on the skin are peeled away. Characteristic of psoriasis.

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15
Q

What is Nikolsky’s sign?

A

A popped blister, where the top layers of skin have been removed.

16
Q

Immunofluorescence staining will be positive for which disorders? What distinguishes them?

A

Pemphigus vulgaris and bullous pemphigus.

  • Autoantibodies (IgG and C3) target desmoglein (desmosomes) in pemphigus vulgaris, so staining will be green throughout the stratum spinosum.
  • Autoantibodies target hemidesmosomes and stain green surrounding the basal layer.
17
Q

A hyperpigmented papule dimples downward into the skin when pinched. What is it, and is it benign or malignant?

A

Dematofibroma. Benign.

18
Q

What are dermatofibromas also called?

A

Fibrous histiocytoma.

19
Q

Where do the basal cells originate epidemiologically?

A

Basal cells arise from the neural crest. The rest of the epidermis arises from the ectoderm.

20
Q

Do basal cell carcinomas metastasize?

A

No, but they are locally invasive. They will grow down into the dermis and even into bone. The mass may get bigger, but it will not break pieces off and travel elsewhere to grow.

21
Q

Why don’t sores from basal and squamous carcinomas heal?

A

They are malignant and have undergone malignant differentiation. They don’t heal normally.

22
Q

What is the classic clinical presentation for squamous cell carcinoma?

A

It most often presents as a nodule with central ulceration and a pink, elevated, indurated border that does not heal spontaneously.

23
Q

Do squamous cell carcinomas metastasize?

A

Not usually on keratinized skin. It’s much more likely when they appear on the lip or genitals.

24
Q

What causes the variation in color in melanomas?

A

Variation (disorganization) of the melanization. Immune response (lymphocytes) may also be clearing some of the melanin-containing cells.

25
Q

What are the two radial patterns of melanomas, and which is more concerning for prognosis?

A

Radial, then vertical. Vertical is more concerning. Over 1.7mm in depth is the line for poorer prognosis.

26
Q

Which skin lesion is a large patch, classically raised around the edges?

A

Tinea corporis (fungal). AKA ringworm (no actual worm).

27
Q

What diagnosis presents as red, dome-shaped skin lesions, particularly in children?

A

Molluscum contagiosum

28
Q

For which skin lesion is sunlight beneficial? What are other treatment options for this disorder?

A

Psoriasis. Corticosteroids or immune modulating therapy.

29
Q

What are Wickham striae? On which skin lesions are they found?

A

Reticular white lines. Lichen Planus

31
Q

What disorder is caused by excessive keratinocyte proliferation?

A

Psoriasis.

32
Q

What virus causes verruca vulgaris?

A

Human papilloma virus

33
Q

What virus causes genital warts?

A

Human papilloma virus

34
Q

Pemphigus Folaceous

A
  • Subcorneal blister

- blister within the stratum corneum

35
Q

Which conditions will give a positive Koebner’s test? (2)

A
  1. Lichen planus
  2. Psoriasis
    - positive Koebner: upon examination, additional lesions will erupt when provoked with mild skin trauma
36
Q

Dermatous herpetiform

A
  • Type 3 hypersensitivity; immune complex deposition or IgA antibody
  • associated with Celiac (same immune reaction to as to gluten)
37
Q

Which skin lesions will give a positive Nikolsky’s sign?

A
  1. Pemphigus Folaceous

2. Pemphigus vulgaris

38
Q

Which skin lesion is involves an autoimmune response using IgA?

A

Dermatitis herpetaform

39
Q

Which skin lesion is associated with having an autoimmune reaction via IgG and C3?

A

Pemphigus vulgaris

MSK Midterm (9 decks)

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