Skin

Question 1

Margins for skin cancer

Answer 1

Scc 4mm is low risk, 6mm if high ( >4mm depth, 2cm width, face, immunocompromised)

Bcc 3-5mm

Melanoma - breslows
1cm 1mm
2cm 2mm

Question 2

Pre malignant skin cancer

Answer 2

Scc- solar/actinic keratosis, Bowen’s, Keracanthanoma - similar looking

Melanoma - multiple days plastic naevi, giant congenital melanocytes navi, xeroderma pigmentosum

Question 3

Meckells tumour

Answer 3

Rare and aggressive
Elderly, sun damage, preorbital
Merkel cell polyomavirus seen

Needs radiotherapy

Question 4

Vibration
Touch
Pressure
Muscle

Nerves receptors

Answer 4

Vibration - pacinian
Touch - meissners
Pressure- merkels + ruffini
Muscle - golgi tendon

Question 5

Adamkiwricz artery

Answer 5

Arises from aorta t9-l2
Can result in anterior spinal cord syndrome

AAA REPAIRS

Question 6

Conus medullaris

Answer 6

Only below L1
UMN
Increased reflex’s, babinski, spascity
Bilateral sensory

L4- S4 Cauda equina = LMN, decreases tone, decreases reflex’s and mild motor dysfunction.