Skin Anatomy/Lesion Descriptions Flashcards

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1
Q

Rank the skin layers from outer skin to lowest layer using the labels below?

  • dermis
  • epidermis
  • subdermis
A
  • epidermis
  • dermis
  • subdermis
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2
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. Keratinocytes get their name from the protein they secrete. What is the main component of this protein?

1 - collagen
2 - fibrous protein
3 - amino acid protein
4 - all of the above

A

2 - fibrous protein
- tough protein that protects the skin
- keratinocytes also secrete glycolipids (sugar + fat) which helps water entering or leaving the body

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3
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. All of the following are the layers of the epidermis. Which of the following is the lowest layer, closest to the dermis?

1 - statum granulosum
2 - stratum basalis
3 - stratum lucidum
4 - stratum corneum
5 - stratum spinosum

A

2 - stratum basalis
- single layer of stem cells
- continually divide to produce new keratinocytes

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4
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. All of the following are the layers of the epidermis. Which of the following is the next layer up from the stratum basalis?

1 - statum granulosum
2 - stratum lucidum
3 - stratum corneum
4 - stratum spinosum

A

4 - stratum spinosum
- contain membranous proteins that look like spines that help stick together

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5
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. All of the following are the layers of the epidermis. Which of the following is the next layer up from the stratum spinosum?

1 - statum granulosum
2 - stratum lucidum
3 - stratum corneum
4 - stratum basalis

A

1 - statum granulosum
- 3-5 layer thick of flat keratinocytes
- begin karatinisation, producing the skin layer
- appear as granules due to keratin precursor and lipid proteins

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6
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. All of the following are the layers of the epidermis. Which of the following is the next layer up from the
statum granulosum?

1 - stratum spinosum
2 - stratum lucidum
3 - stratum corneum
4 - stratum basalis

A

2 - stratum lucidum
- 2-3 cell layer of dead karatinocytes
- appears in thick skin on body

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7
Q

The epidermis is composed of keratinocytes which are essentially epithelial cells. All of the following are the layers of the epidermis. Which of the following is the next layer up from the stratum lucidum?

1 - stratum spinosum
2 - statum granulosum
3 - stratum corneum
4 - stratum basalis

A

3 - stratum corneum
- uppermost layer made up of 20-30 cells thick
- glycolipid = cement
- dead keratinocytes are bricks

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8
Q

What cell can be found at the bottom of the epidermis layer that gives skin its pigmentation?

1 - langerhans cell
2 - neutrophils
3 - melanocytes
4 - desmosome

A

3 - melanocytes

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9
Q

What is the main immune cell located in the epidermis layer of the skin?

1 - langerhans cell
2 - neutrophils
3 - melanocytes
4 - desmosome

A

1 - langerhans cell
- form of antigen presenting dendritic cells

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10
Q

What is the name of the seal that seals the skin and nails?

1 - lunula
2 - cuticle
3 - nail root
4 - nail plate

A

2 - cuticle
- if damaged water can enter here causing chronic inflammation and nail damage

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11
Q

How many different skin types are there based on the Fitzpatrick scale?

1 - 2
2 - 4
3 - 6
4 - 8

A

3 - 6

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12
Q

What is the primary source that determines our skin type?

1 - langerhans cells
2 - layers of stratum corneum
3 - melanin levels
4 - keratin levels

A

3 - melanin levels
- secreted by melanocytes

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13
Q

Pheomelanin is a form of melanin. Do individuals with high levels of Pheomelanin have light (1 of scale below) or darker skin (6 on nscale)?

A
  • light skin
  • freckles, ginger hair
  • typically Pheomelanin is red in colour
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14
Q

Eumelanin is a form of melanin. Do individuals with high levels of Euomelanin have light (1 of scale below) or darker skin (6 on nscale)?

A
  • darker skin
  • Caribbean
  • typically Eumelanin is brown in colour
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15
Q

Are patients with more Eumelanin (brown scale 5-6) or Pheomelanin (red/pink scale 1-2) more likely to develop skin cancer?

A
  • Pheomelanin (red/pink scale 1-2)
  • more sensitive to UV rays and to burn
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16
Q

Which of the following is the definition of Erythroderma?

1 - widespread intense reddening of the skin
2 - reddening of specific joints
3 - swelling and redness of joints
4 - patches of intensely red skin

A

1 - widespread intense reddening of the skin

17
Q

Which of the following describes hyperpigmentation?

1 - decreased pigmentation
2 - complete loss of pigmentation
3 – increased pigmentation

A

3 – increased pigmentation

18
Q

Which of the following describes hypopigmentation?

1 - decreased pigmentation
2 - complete loss of pigmentation
3 – increased pigmentation

A

1 - decreased pigmentation

19
Q

Which of the following describes depigmentation?

1 - decreased pigmentation
2 - complete loss of pigmentation
3 – increased pigmentation

A

2 - complete loss of pigmentation

20
Q

What is the main imaging type used in dermatology clinics?

1 - ultrasound
2 - microscopes
3 - dermatoscopy
4 - MRI

A

3 - dermatoscopy

21
Q

In skin conditions, which 2 of the following are the most common swabs that are taken for skin conditions?

1 - bacterial
2 - fungal
3 - parasitic
4 - viral

A

1 - bacterial (black)
4 - viral (yellow or green)

22
Q

Scrapings and clippings are typically used for which of the following?

1 - bacterial
2 - fungal
3 - parasitic
4 - viral

A

2 - fungal

23
Q

Topical treatments are those that are applied directly to the skin. Which of the following is best for dry skin?

1 - ointment
2 - gels
3 - lotion
4 - cream

A

1 - ointment
- but can be very messy

24
Q

Topical treatments are those that are applied directly to the skin. Which of the following should not be used on skin in a smoker?

1 - ointment
2 - gels
3 - lotion
4 - cream

A

1 - ointment
- has highest oil based contents so flammable

25
Q

What is the most commonly used approach to take a skin biopsy in dermatology?

1 - open surgery
2 - MOHS approach
3 - punch biopsy
4 - clipping

A

3 - punch biopsy
- sent to cytology in formaldehyde

26
Q

There are 4 classes of potency when we think about topical steroids used to treat skin conditions, mild, moderate, potent and super potent. Match the following strengths of steroid with the correct steroid?

  • Hydrocortisone
  • Clobetasone butyrate
  • Betamethasone valerate
  • Clobetasol propionate
A
  • Mild = Hydrocortisone
  • Moderate = Clobetasone butyrate
  • Potent = Betamethasone valerate
  • Super potent = Clobetasol propionate
27
Q

Typically how long should topical steroids be used for?

1 - 3-5 days
2 - 1-2 weeks
3 - 3-4 weeks
4 - lifelong

A

2 - 1-2 weeks
- slow releasing use alternative days
- wean patients off slowly incase of rebound effect

28
Q

What is the term used to describe when a steroid has been used too much and it stops working?

1 - prophylaxis
2 - anaphylaxis
3 - therapeutic
4 - tachyphylaxis

A

4 - tachyphylaxis
- switching to a different steroid can be effective at alleviating this

29
Q

Which of the following is NOT a long term effect of topical steroid use?

1 - Delay wound healing
2 - Worsening of infection
3 - Skin atrophy
4 - Telangiectasia/Striae
5 - Contact dermatitis
6 - Perioral dermatitis
7 - Hyperglycaemia
8 - suppress the pituitary /adrenal axis

A

7 - Hyperglycaemia

30
Q

Naevi is the medical name for a mole. What is the term used to describe a neavi where the hosts immune system has mounted an immune response against the naevi?

1 - benign naevus
2 - halo naevus
3 - congenital naevi
4 - seborrheic keratosis

A

2 - halo naevus
- pallor around the mole, but not a marker of malignancy

31
Q

Are dysplastic naevi dangerous?

A
  • typically no
  • however, if they are dysplastic they could become malignant
32
Q

Actinic keratoses (also called solar keratoses) are dry, scaly patches of skin that have been damaged by the sun exposure. Do these typically affect the outer layer of skin or affect deeper layers of the skin?

A
  • just the surface of the skin
  • BUT very rarely become invasive beyond the basal cells
33
Q

Squamous cell carcinoma in-situ (SCC in-situ). These are dry, scaly patches of skin that have been damaged by sun exposure. Do these typically affect the outer layer of skin or affect deeper layers of the skin?

A
  • can be both
  • typically these can cover the depth of the epidermis, BUT very rarely become invasive beyond the basal cells
  • also called Bowens disease
34
Q

Actinic keratoses and squamous cell carcinoma in-situ (SCC in-situ) can be treated with all of the following, except which one?

1 - creams (Effudix)
2 - freezing
3 - radiotherapy
4 - PDT
5 - Curettage & Cautery

A

3 - radiotherapy
- very uncommon

Curettage = inject local anaesthetic, scrape and repeat

Efudix = 2 cycles typically

35
Q

Seborrhoeic keratoses are extremely common growths caused by a build-up of skin cells. Are these dangerous?

A
  • no they are benign
  • typically increase in number as we age
36
Q

What is a Lentigio melanoma?

1 - metastatic melanoma
2 - melanoma cells on surface of the skin
3 - benign melanoma
4 - combination of SCC and melanoma

A

2 - melanoma cells on surface of the skin
- typically not an invasive melanoma, but 10% can become invasive

  • treated by excision