Quiz 5 (test 3) Flashcards
True or false… in regards to breast disease, the older the patient the greater the likelihood that it is malignant
True
What are three common symptoms of breast disease (not specific for cancer, fibrotic growths, or cysts)?
Pain
Palpable masses
Nipple discharge
Mammography screenings should start at age ___. Why?
~40 years
Younger women have denser breast tissue making it difficult to identify a mass.
Mammography detects ___, shows ___, and identifies ___.
Density
Architectural distortions
Calcification
___% of breast cancers that are not detected by mammography can be detected by ___.
~10%
Palpitation
True or false… mammography can be used to help guide biopsy needle in order to sample a growth
True
Mammography is __-__% predictive
85-95%
What is acute mastitis? What causes it?
Breast abscesses and necrosis. It may be infectious or non-infectious
Can be caused by plugged ducts
Acute mastitis is typically associated with whom?
Women who are breast feeding?
Fat necrosis of breasts is usually associated with what?
Trauma (such as from a seat belt during an accident)
What are the fibrocystic changes that can occur in breasts?
Fibrosis
Cysts
Palpable changes that can make detection of breast cancer difficult
There is a higher risk of breast cancer in the ___ types of breast cysts
Aggressively proliferative
Breast cysts typically occurs in ___-___ olds and typically (does/does not) occur after menopause
20-40
Does not occur after menopause
True or false… breast cysts rarely calcify and can be readily distinguished from cancer on a mammogram.
False. It can calcify. It can look like cancer on mammogram.
What are the most common benign neoplasms of the breast? Describe them.
Fibroadenomas
Mostly CT
Well circumscribed
True or false.. you should always remove benign neoplasms of the breast
False.. dont typically remove unless uncomfortable
Breast carcinoma rarely occurs in women under ___ years of age.
25
Who is breast carcinoma most common in?
The more affluent societies have the highest incidence regardless of race; suggests mostly caused by environment
Breast carcinoma has a ___% incidence by 70 years of age; fatality in 1 out of ___
~30%
9
5-10% of breast carcinoma cases are inherited. What gene is involved?
BRCA1 and BRCA2 are the most common inherited genes. - single strong gene factor
Family “tendency” (__-__% risk) means what?
20-30%
Not a single strong gene but a pattern of occurrence in family
What % of breast carcinoma cases are considered sporadic, meaning no family pattern, just chance?
70-80%
There are about ___ new breast cancer cases in the US each year.
250,000
What are three risk factors for breast carcinoma?
Diet high in animal fat
Obesity
Delayed first pregnancy
What are the symptoms of breast carcinoma?
Pain
Masses (assessed by palpitation, mammography, ultrasound, MRI, or tissue biopsy)
Swollen, pitted surface (peau d’ orange) and enlarged axillary lymph nodes
What is the prognosis of breast carcinoma based on?
Size
Axillary node status
Distant metastasis
The five year survival rate of stage 0 is ___
The five year survival rate of stage 4 is ___
92%
13%
If the breast tumor expresses estrogen/progesterone receptors, what kind of treatment may be used?
Hormonal treatment
Generally, all types of breast cancer are ____, originating from ____ in the ____.
Adenocarcinomas
Epithelial cells
Terminal ducts
Invasive carcinoma makes up ___% of breast cancer cases
75-85%
Most types of breast cancer are ___ and the incidence (increases/decreases) with age and have invasive and non-invasive types
Ductal
Increases
____ are procedures that remove smaller breast masses
Lumpectomies
Benign epithelial lesions typically express ___ changes. (__% of women have microscopic cysts associated with epithelial tissue_)
Fibrocytic
60%
Cervical cancers are ___-associated. ___ neoplasms represent most cervical cancers
HPV
Squamous cell
What do you do to detect early cervical cancers?
Pap smear
What are some risk factors for developing cervical cancer?
Multiple sex partners
Immunosupression
Early age of first sexual contact
Oral contraceptives for over 5 years
Nicotine use
What are some thing that can cause abnormal bleeding of the endometrium?
Polyps
Endometritis
Endometrial hyperplasia
Cancers
Anovultory cycles
What are three causes of endometrial polyps
HTN
Obesity
Late menopause
Less than __% of endometrial polyps progress to cancer
2%
Leiomyomas are ___ neoplasms. They are ___-dependent. They cause bleeding and are painful. They may cause ___. They are (very/rarely) frequent.
Benign smooth muscle neoplasms
Estrogen-dependent
Infertility
Very frequent (10-15%)
What kind of cancer is endometrial cancer?
Adenocarcinoma
What are three risks for endometrial cancer?
Obesity
Diabetes
HTN
What is the treatment for endometrial cancer?
Hysterectomy-treatment of choice
Radiation/chemotherapy adjunctive
What is the most common cause of endometritis (infections)?
IUDs
True or false… endometrial hyperplasia can progress to cancer
True
Endometrial hyperplasia has an exaggerated response due to excessive ___.
Estrogen. (Excessive ovarian activity)
What is the treatment for endometrial hyperplasia?
Progesterone
Hysterectomy
What is preeclampsia?
Secondary hypertension in pregnant women of at least 20 weeks gestation.
Often associated with diabetes
Exact cause is unknown but appears to be associated with abnormal circulation in the placenta
Is a follicular ovarian mass a non-neoplastic cyst or a neoplastic cyst?
Non-neoplastic
Is an endometrioid ovarian mass neoplastic or non-neoplastic?
Neoplastic
Most neoplastic ovarian masses (are/are not) sporadic. Contraceptives (increase/decrease) risk. __% are hereditary due to the ___ genes. What is the treatment?
Are sporadic
Decrease risk
10% hereditary due to the BRCA 1&2 genes
Treatment: total hysterectomy + removal of surrounding tissue + chemotherapy
What are three symptoms of ovarian masses?
Pelvic pain
Pelvic mass
Abdominal bleeding
True or false.. there are effective screening techniques for ovarian masses
False. Unlike cervical cancer, there is no effective screening for ovarian cancer
Natural estrogens are ___ hormones.
Synthesized estrogens may be ___
Steroid
Non-steroidal
True or false.. Estrogens and progestins can cross cell membranes and activate estrogen receptors inside the cells, thus modulating the expression of genes.
True
What are the three stages of the menstrual cycle?
Menstrual stage - menses
Follicular stage - proliferative
Luteal stage - secretory
True or false… as populations age, they spend more time in menopause (females) or andropause (males)
True
Name and describe the three different types of natural estrogens
E1 - estrone - predominant during menopause
E2 - estradiol - predominant during reproductive years
E3 - estratriol - predominant during pregnancy
Name one steroidal synthetic estrogen and one non-steroidal synthetic estrogen
Steroidal - ethinyl estradiol
Non-steroidal - diethylstilbesterol
What are six physiological functions of estrogen?
Sexual maturity
Increased CNS excitability
Increased endometrial and uterine growth
Maintain skin elasticity
Reduce bone resorption
Increase blood coagubility
What are the clinical uses of estrogen supplementation?
Primary hypogonadism
Postmenopausal problems
What are the guidelines for clinical use of estrogens?
Always use the smallest dose for the shortest period of time possible
Sometimes local creams are preferred to minimize exposure
What are seven adverse effects to estrogen supplementation?
Postmenopausal bleeding
Nausea
Breast tenderness
Migraines
HTN
Hyperpigmentation
Increases some cancers (breast and endometrial)
What are three contraindications for the use of estrogen supplementation?
Liver disease (slows metabolism)
Breast/endometrial cancers
Thrombolytic disorders
Progestins are made from ___. They are present in males, but less than females. ___ is the most important progestin in humans
Cholesterol
Progesterone
Progesterone is the precursor to what?
Estrogen
Androgen
Adrenocortical steroids (cortisol)
Testosterone
Estradiol
What is the half life of progestins?
~5minutes (very short acting)
What are the effects of progestins?
Increase fat deposition
Decrease CNS excitability (antiseizure - opposite of estrogen)
Increase aldosterone - increase Na retention - increase BP - increase water retention and blood volume
Increase body temperature
What are three clinical uses of progestins?
Replacement therapy
Oral contraception
Long-term ovarian suppression (dysmenorrhea or endometriosis) - in contrast to estrogens, no problem with bleeding or clotting
When is the use of progesterone contraindicated?
Breast cancer is a risk
Severe HTN or heart disease is a risk
Which is more effective for contraception, combination or progestin only?
Combination (progesterone and estrogen). It decreases ovulation close to 100%
Progestin only decreases ovulation 50-80%
In addition to decreasing ovulation, what else does combination contraceptives do? What about progestin-onlys?
Combination - decreases ovulation, conception, implantation
Progestin only - decreases ovulation, thickens mucus and reduces sperm penetration, impairs implantation
What are the three different types of combinations of contraceptives?
Monophasic - constant doses of both estrogen and progesterone
Biphasic - dosage of one or both change one time during cycle
Triphasic - dosages change 2 times per cycle
What is the “minipill”?
Progestin only
Has fewer side effects but less effective
Usually a secondary option because of drawbacks
Implantable contraceptive systems can be effective for ___ years.
2-4 years (Norplant system)
In addition to oral contraceptives, what are some delivery forms for contraceptives?
Implantable
Injections
Intravaginal rings
IUDs (with or without estrogen/progestin)
Transdermal combinations.
True or false… the side effects of combination contraceptives are permanent even after discontinuation
False. They reverse
Combination contraceptives can cause (reduced/increased) ovarian function and size. (Reduced/increased) breast size and tenderness. (Reduced/increased) HR and BP. (Hyper/hypo)-pigmentation, especially around the eye. Mild ____, breakthrough ___, and ___. May interact with what drugs? (Reduce/increase) sebum production in skin.
Reduced ovarian function/size
Increased breast size/tenderness
Increased thrombolytic events
Increased HR and BP
Hyperpigmentation
Nausea, bleeding, headaches
Can interact with antibiotics that disrupt GI flora. (Normal absorption of contraceptives from GI system is dependent on this flora)
Reduce sebum production, causing dry skin but reduces acne
What are the side effects of estrogen-only replacement?
Increase risk of ovarian, endometrial, and breast cancer after 10 years of use.
Nausea, breast tenderness, migraines, HTN. These effects are dose dependent
What are the uses for progestins?
Oral contraception
Menstural disorders, irregularity, heavy discharge
Acne
Name three antagonists of progestins.
Tamoxifen
Mifepristone
Danazol
What is tamoxifen?
Partial antagonist
Blocks actions of estrogen in breast.
Used to treat breast cancers
What is mifepristone?
Morning after contraceptive
Blocks progesterone and glucocorticoid receptors
Prevents implantation of fetus
99% effective if used within 3 days
What is danazol?
Suppresses ovarian function
Has a masculinizing effect
What is clomiphene (clomid)?
Partial estrogen agonist
Ovulation-inducing for promoting fertilization and pregnancy
increased risk of multiple births (twins)
True or false… testosterone is an androgen
True
What are some uses of testosterone?
Converts to estradiol
Replacement therapy for males
Gynecological disorders (reduces breast size (gynecomastia)
Has protein anabolic effects (helps replace muscle loss)
Growth stimulation - can prematurely close growth plates in growing adolescents
Counter some age-related loss of muscle mass
True or false… testosterone can cause masculinization effects in women. It is abused for muscle and strength building. It can cause acne, aggressiveness
True
True or false… ketoconzaole can inhibit the synthesis of testosterone. It is used to treat prostate carcinoma in men
True
What is oxytocin used for?
Induce/augment labor
What is metoclopramide?
D2 antagonist that stimulates prolactin and lactation
___% of calcium is stored in bones
99%
In the adult, the ___ are the primary site of hematopoeises
Bones
Bone undergoes constant remodeling. ___ bone resists compression forces. ___ bone is thick and resists bending forces
Medullary
Cortical
The ____ is a tough fibrous membrane that covers bone surfaces except at joints. It is well innervated.
Periosteum
Osteogenesis imperfecta is deficient or defective type ___ collagen (too little bone).
1
What are the symptoms of osteogenesis imperfecta?
Generalized osteopenia Multiple fractures and bone deformities Malformed teeth (dentin deficiency)
Blue sclera
What is an achondroplastic dwarf?
And individual with reduced function of growth plates
What is osteopetrosis?
Defective osteoclasts
Bone is brittle and too dense
What is osteomalacia?
Softening bone due to vitamin D deficiency
Delayed eruption of teeth and defects in the dentin and enamel
What is Albers-Schoenberg disease?
Impaired osteoclasts, reduces bone resorption. Associated with…
Anemia
Bone fractures
Blindness
Deafness
What is is osteitis deformans?
Mixed stages of osteolysis and osteogenesis
What is another term for adult rickets?
Osteomalacia
True or false… GI malabsorption syndrome and/or lack of sunlight exposure can lead to acquired bone disease
True. Scurvy and rickets
True or false. Hyperparathyroidism can be a form of acquired bone disease
True
Constantly releases Ca2+
Adenoma in parathyroid can cause it
Who is osteoporosis common in?
Elderly women after menopause
True or false.. Osteomalacia is vitamin D deficiency. Lack of normal mineralization (usually kidney related)
True
What are the genetic and behavioral causes of osteoporosis?
Genetic: age, low estrogen, fair hair and skin, tall and thin
Behavior: inactivity, smoking/alcohol, malnutrition, medicaiton (chronic corticosteroids)
____ people in the US have osteoporosis. ___ are women over ___ years of age and have at least one osteoportoic fracture.
10 million
1/3 women over 50
What is kyphosis?
Abnormal forward curvature of the spine
What is scoliosis?
Abnormal lateral curvature of the spine
What are the 6 different types of fractures?
Complete
Closed (overlying tissue intact)
Comminuted (bone splintered/crushed)
Displaced
Open (fractured bone pierces skin)
Greenstick (bone cracks through only one side (common in children not adults)
Osteomyelitis is inflammation of bone/marrow. What are the two ways of getting it?
Blood-born (hematogenous spread (pyogenic infections such as staph aureus or salmonella)
Direct (trauma from compound fractures)
What is pott disease?
Granulomatous osteomyelitis associated with TB or fungi.
Common in the spine
How is diabetes related to osteomyelitis?
Can cause osteomyelitis due to poor circulation in the extremities. If chronic, can form a drainage site and can even become osteosarcoma
Osteoarthritis is a degenerative joint disease. It has loss of ____ with secondary changes in ___. It presents in some degree in most people over ___ years of age. Symptoms (worsen/are relieved) with excessive use. Its due to wear and tear. It is the most common type of joint pain. There are (no/considerable) inflammatory changes. Bones swellings are called ___.
Articular cartilage
Bone
65
Worsen
No inflammatory changes
Heberden nodes
Rheumatoid arthritis is more systemic and bilateral than osteoarthritis. Most common form is of ____ disease. It has a ___% prevalence. It is most common in what race? What race is it least common in?
Autoimmune
1%
Caucasians
Asians
Rheumatoid arthritis onset of age is ___. __% of cases are female. (Juvenile RA). Associated with joint swelling, pain, and tenderness that (worsens/is relieved) with use. Can cause extreme distortions of joints and surrounding bone (deforming and debilitating).
25-50
75% female
Is relieved by use
RA may have systemic symptoms such as ___, ___ and ___. Other areas also affected are…
Fever, weakness, malaise
Ulcers
Pulmonary nodules and fibrosis
Carditis and pericarditis
Vasculitis
What are some other inflammatory arthritities?
Psoriatic arthritis
Other autoimmune diseases (lupus erythematosus, scleroderma)
Post-infections (rheumatic fever)
Infections (staph/strep/TB)
Gout (cystillaized uric acid)
Lyme disease, if not treated - arthritis and neurological consequences
What is the primary cause of gout?
Reduced renal excretion of purine (uric acid’s break down product)
What is the primary treatment of gout?
Allopurinol. Decreases the synthesis of purines
What are the symptoms of gout?
Hot, swollen, pain in joints, progressive joint destruction, gouty tophi (crystallized aggregates of uric acid)
What is pseudo-gout?
Crystal deposits of calcium pyrophosphate
Name three ways to treat gout.
Colchicine
Allopurinol
Indomethacine
What are ganglion cysts?
A cyst resulting from CT around joints. Often painful
What is Marfan syndrome?
Hereditary connective tissue disease caused by a mutated fibrillin gene with the following symptoms..
Spider-like fingers
Tall growth
Necrosis of aorta
Malignant carcinomas spread to bone tumors most likely to come from the ___, ___, ___, ___, and ___
Lungs
Prostate
Breast
Thyroid
Kidneys
Bone tumors most likely seen in maxilla or mandible are…
Osteomas - immature bone
Giant cell tumor - benign, but aggressive
Fibrous dysplasia - not malignant
Osteosarcoma - most often in adolescent or older patient
Ewing sarcoma - seen in 10-20 year olds. 2nd most frequent sarcoma after osteosarcoma
How many bone sarcomas occur per year in the US?
8000
What is the most frequency form of bone malignancy? Who is most likely to get it? Where is most frequent?
Osteosarcoma
Most likely in adolescents or geriatric patients
Usually in long bones or sometimes the mandible
What are benign tumors of the cartilage? Do not see in the mandible or maxilla.
Osteocondroma
What is chrondrosarcoma?
Malignancy of cartilage
What is fibrous dysplasia?
Fibrous/ fibro-osseous tumor
Benign medullary bone that does not properly mature
Often in the jaws
What is the 2nd most frequent sarcoma after osteosarcoma?
Ewing sarcoma
How many soft tissue tumors are found each year in the US?
12,000
Name 6 different soft tissue tumors.
Lipoma
Liposarcoma
Fibrous tumors
Fibrosarcoma
Rhabdomyosarcoma
Smooth muscle tumors
Describe lipomas
Very common
Don’t usually require treatment
Are liposarcomas malignant?
Yes
True or false… fibrous tumors are usually reactive
True
What are malignant neoplasms of fibroblasts?
Fibrosarcoma
What are rhabdomyosarcomas?
Skeletal muscle tumors
Most frequently in head and neck region
Rare
What are two types of smooth muscle tumors?
Benign leiomyomas
Leiomyosarcomas (deep soft tissue)
True or false… muscular dystrophy is a nonifnlammatory myopathy and is the most common in duchenne muscular dystonia
True
What are the symptoms of muscular dystrophy?
Progressive weakness of voluntary muscles and breakdown of muscle tissue
Can occur anytime and anywhere
Represents a group of genetic disease
Congenital myopathies tend to present with congenital ___ and ___
Hypotonia
Weakness
What is rhabdomyolysis?
Diffuse destruction of skeletal muscles
Rhabdomyolysis may develop with ____. Can be cause by some drugs such as ___. Describe acute rhabdomyolysis.
Flu episode
Statins
Acute: muscles are tender and swollen
What are some denervation diseases?
ALS
Polio
Typically result in muscle degeneration
Myasthenia Gravis is an inflammatory myopathy. What are its symptoms?
Weakness in skeletal muscles responsible for breathing and mobility
Worsens with activity and improves with rest
Often includes other skeletal muscles such as those for eyelids, facial movement, chewing, talking, and swallowing.
What causes myasthenia Gravis?
Auto-antibodies kill Ach receptors; thymus may contribute to formation
Not inherited
What is the treatment for myasthenia Gravis? What is the prognosis?
Acetylcholinesterase inhibitors - pyridostigmine
Immunosuppressants - prednisone, rituximab
Prognosis is usually good with proper treatment
Name three cell types of the skin
Squamous cells
Basal cells
Melanocytes
What are the appendages of the skin?
Apocrine glands (sweat, milky with odors - located near hair follicles)
Eccrine glands (found widely distributed, sweat is watery for thermo control)
Sebaceous (also located near hair follicles, secrets oily sebum for lubrication and to prevent water loss)
What is a macule?
Flat
Circumscribed
<5mm
What is a papule?
Elevated dome or flat topped
<5mm
What is a nodule?
Elevated dome
> 5mm
What is a plaque?
Elevated
Flat-topped lesion
> 5mm
What does lichenfication mean?
Thickened skin due to repeated rubbing
What is a pustule?
Discrete, pus-filled raised lesion
What is a scale?
Dry, plate-like excrescence, imperfect cornification
What is a vesicle?
Fluid-filled
Raised area
<5mm
What is acantholysis?
Loss of intercellular adhesion keratinocytes
Epidermis falls apart and sloughs off
What is acanthosis?
Diffuse epidermal hyperplasia (thicker than normal)
What is excoriation?
Traumatic breakage of the skin (for example as a result of intense scratching)
What is a bulla?
Fluid-filled raised area
> 5mm
What is dyskeratosis?
Abnormal keratization
Deeper in epidermis than normal
What is hyperkeratosis?
Hyperplasia of stratum corneum
What is spongiosis?
Intercellular edema of epidermis
What is papillomatosis?
Surface elevation caused by hyperplasia
What is a cyst?
Fluid filled sac lined with true epithelium
What is a granuloma?
Chronic inflammatory lesion consisting of granulation tissue
What is an abscess?
Acute inflammatory lesion with pus, surrounded by a fibrous wall
What is cellulitis?
Acute diffuse swelling along fascial planes separating muscle bundles
Define each of the following descriptive words
Calor
Tumor
Rubor
Dalor
Funcio laesa
Urticaria
Calor - warm
Tumor - swelling
Rubor - reddening
Dolor - painful
Funcio laesa - loss of function
Urticaria (hives) - associated with mast cell degrandulation and resulting swelling, redness, and itching.
Name 4 different types of acute inflammatory skin pathologies
Urticaria (hives)
Eczematous dermatitis
Allergic contact dermatitis
Erythema multiforma
Urticaria is ___ mediated by antigens and ___. Treat with ___ or ___.
Hypersensitivity
IgE
Antihistamine
Steroids
Eczematous dermatitis (___ most common, delayed hypersensitivity reaction). Can be prurience, edematous or oozing plaques/vesicles. Can be caused by drugs, reaction to UV or irritating chemicals. Can be associated with ___ or ___.
Contact dermatitis
Asthma or allergic rhinitis
Allergic contact dermatitis - ___ memory of the reaction so that future contacts cause an [increased/decreased] dermatitis reaction.
Cellular
Increased
What is erythema multiforma?
Hypersensitivity to infections and drugs
Dermal edema
Can have blisters and necrosis
Wide range of expressions and severity
What is Stevens Johnson syndrome?
A type of severe, life threatening reaction of erythema multiforma due to reaction to medicines such as sulfonamides and salicylates
Can also be a reaction to infections such as herpes virus or fungal infections.
Advanced can have epidermal necrosis with blisters
T-cells attacking antigen and surrounding cells (basal cells)
What drugs cause Stevens johnsons syndrome? ___ cells attack what cells?
Sulfonamides
Salicylates (aspirin)
T cells attack basal cells
Name three types of chronic inflammatory skin diseases
Psoriasis
Lichen planus
Systemic lupus
What is psoriasis? What is it sometimes accompanied by? What is the treatment? What does it look like?
Inciting antigen, auto-rejection or environmentally induced
Can be accompanied by some increase in heart attacks and arthritis
Treatment includes NSAIDs and immunosuppressant drugs
Well-marked by pink to salmon colored plaques
Regular acanthosis in epidermis-thinning of epidermis (with increased bleeding)
What does lichen planus look like? Who does it most commonly occur in? How long does it take to resolve? What causes it?
Lace-like white markings, referred to as “wickham striae”. Hyperkeratosis and epidermal hyperplasia. Occurs in extremities and oral cavity
Middle age
Resolves after 1-2 years although often persists in oral cavity
Unknown inciting mechanisms- although hyperactive T cells may be involved.
What is systemic lupus erythematosus? What is it caused by? How do you manage it?
Chronic autoimmune response. Affects skin. Can cause butterfly rash on face
Caused by environmental factors/triggers such as drugs, UV radiation, viruses, stress
Manage with NSAIDs, steroid, antiimmune drugs. Can cause long-term effects such as blood clots seizures, even heart attacks
What is impetigo?
Infectious dermatosis (usually caused by staph and strep infections superficial).
What is infectious dermatosis? How do you treat it?
Bacterial infection on face and extremities
Contagious through contact (primarily kids)
Honey color crust, pustules, use topical antibiotics such as tetracycline
Fungal skin infections such as tinea (ring worm) or candida) often infect ____ patients. Very common presentation is…
Immunocompromised
Erythematosus macules, often pruritic
What are some viral infections of the skin?
Warts (HPV). Contagious by direct contact. Can auto-inoculate and spread/epidermal hyperplaisa
Papillo mitosis
What is the prominent feature of pemphigus?
Bulbous blistering
Painful flaccid blister like. Deep erosions and crust after ructions. Hypersensitivity reaction.
How do you treat dermatitis herpetiformis?
Use immunosuppressive treatment
Tend to be auto-immune responses
What does herpes simplex look like?
Group vesicles
Epidermal acantholysis
Vesicles
Sloughing
Herpes zoster has ____ distribution. What is the danger with that?
Dermatomal distribution
Can get trigeminal nerve involvement and can be very dangerous spreading to surrounding tissue such as eye or brain
VCV can cause ___ later in life in those who experienced ___ when young. What does it look like?
Shingles
Chicken pox
Expresses as a band of rash that often itches, burns or throbs. It may persist for weeks to months. Usually relieved by anti-inlfammtories or opioid analgesics
In extreme cases it becomes like an intense neuralgia and does not respond to traditional analgesics
Not contagious, typically does not repeat, but can in some cases
What is pemphigus? How do you treat it? What kind of cells are associated with it?
Has acanthosis
Blister formation
Autoimmune
Typically treat with steroids
Pemphigus vulgaris has tzank cells.
Acne is infected hair follicles. What is the difference between blackheads and white heads?
Blackheads - opened comodones
Whiteheads - closed comodones
Causes cysts, pustules, abscesses, and scarring
True or false… drugs such as contraceptives, steroids, and testosterone make acne worse.
True? I’m confused though because earlier in the study guide it says that estrogen contraceptives reduce sebum production and are used for acne. ??
What causes acne vulgaris?
Hormone changes (increase of sex hormones)
Blocks hair follicle and sebaceous glands
Hair follicle have proliferation of lining cells and cellular plug and traps bacteria, cellular debris, and sebum
Gland ruptures and contents spreads to form cysts, abscesses, and scarring, area is inflamed and swollen
What do you use to treat acne vulgaris?
Antibiotics (tetracycline)
Keratolytics
Drying agents
Vitamin A (topical and systemic - accutane) *do not use in pregnancy!!
UV exposure
What is perioral dermatitis? Who is most commonly found in? What causes it?
Follicular papules, vesicles and pustules
Found in young women
Long-term steroid use or cosmetic use. Hormonal changes
What is the appearance of seborrhea keratosis?
Coin-like plaques stuck on appearance. Tan to dark brown glandular surface. Found in the elderly or middle age
Can be generally spread
What dos actinic keratosis look like? What causes it? Is it malignant?
Brown to red, rough scaly texture
UV exposure in fair-skin people
It is premalignant
Melanocytic nevi (moles) are ___ neoplasms from ___. They are variable in appearance. They have ___-defined borders and not predisposed to cancer. Pigmented nevus.
Benign
Melanocytes
Well-defined borders.
Dysplastic nevi have ___, ___ borders. They are ___. If > ___ lesions, have increased risk for melanoma.
Irregular, assymetric borders
Sporadic
> 10
Most malignant skin conditions are __-induced free radicals, especially in fair skinned persons
UV
What is the most common skin malignancy? Describe it. How do you remove it?
Basal cell carcinoma
Least aggressive. Slow growing. But can be disfiguring if not removed early and can ulcerate and bleed.
Most common worldwide
Remove with local incision. Does not metastasize
What is the second most common skin malignancy? Describe it.
Squamous cell carcinoma.
Intermediate aggression. No metastasis.
Red scaling plaques - locally aggressive. Often presents as a scaling ulcerative nodule. Can have keratin pearls (islands of neoplastic skin cells)
Remove with surgery
What is the least likely, but most aggressive skin malignancy? Describe it.
Melanoma
Metastasizes
Warnings: rapid enlargement of nevus; new pigmented lesion not from pre-existing nevi.
Irregular borders, irregular surface and colors
Usually is superficial and spreads
Caused by UV exposure and genetics
Poor prognosis if metastasized (common sites are lungs, liver, and brain)
Common sites of melanoma metastasis is ___, ___, and ___. It has a [high/low] mitotic rate. Lack of immune response to slow spread especially once it hits lymph nodes. Superficial lesions are typically [good/bad] prognosis. Poor prognosis with metastatic disease, high mitotic rate and poor immune response.
Lungs, liver, brain
High
Good
