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Oral Boards > Skin and soft tissue > Flashcards

Skin and soft tissue Flashcards

1
Q

Lymphoscintigraphy for head and neck melanoma should include this imaging modality

A

SPECT

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2
Q

MSLT II surveillance for patients with stage III melanoma

A

Ultrasound q4 months for 2 years, then every 6 months for 3 years. then annually until year 10

Plus annual PET/CT

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3
Q

Borders of superficial inguinal node dissection

A

Inguinal ligament, sartorius laterally, adductor longus medially.

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4
Q

Consideration for adjuvant treatment after node dissection for melanoma

A

RAdiation (decreases local recurrence, but doesn’ affect survival)

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5
Q

Difference in adjuvant treatment for MCC compared to melanoma

A

Adjuvant radation to resection site in tumors > 2 m

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6
Q
A

Squamous cell carcinoma

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7
Q
A

basal cell carcinoma

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8
Q

Margins needed for squamous cell carcinoma

A

negative (preferably 0.5 cm)

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9
Q

Risk factors for sarcoma

A
  1. > 5 cm
  2. elarging
  3. deep to fascia
  4. recurrent after excision
  5. painful.
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10
Q

List of extremity soft tissue sarcomas

A
  1. Undifferentiated /unclassfied soft tissue sarcoma (previously malignant fibrous histiocytoma)
  2. Liposarcoma
  3. leiomyosarcoma
  4. synovial sarcoma
  5. malignant peripheral nerve sheath tumor
  6. Rhabdomyosarcoma
  7. fibrosarcoma
  8. angiosarcoma
  9. epithelioid sarcoma
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11
Q

Work up for soft tissue sarcoma of extremity

A
  1. H&P looking for growth or symptoms, and exam of lymph node basins
  2. MRI (enhancing on T2 whereas a benign lesions looks like surrounding tissue)
  3. Core needle biopsy positioned in way that needle tract can be removed upon excision.
  4. If core nondiagnostic, surgical excisional biopsy
    1. Complete excision for lesion < 3 cm
    2. Wedge for lesion > 3 cm
  5. CT scan of chest if diagnosis made
  6. Multidisciplinary tumor board review
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12
Q

General treatment strategy for extremity sarcoma

A
  1. Excision and observation for small, low-grade
  2. Excision and ajuvant radiation for large, high-grade (sometimes chemotherapy)
  3. Neuadjuvant chemoradiation can be considered to spare functional outcome, but should be discussed at Multi disciplianary board
  4. Intraoperative analysis with pathology to assess for need to take more tissue.
  5. Orient specimen and place clips for radiation.
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13
Q

Work up for retroperitoneal sarcoma

A
  1. CT abdomen and pelvis with IV/PO contrast
  2. Germ cell tumor markers (AFP, BHCG)
  3. Core needle biopsy
  4. Staging work up with CT chest
  5. Discussion at multidisciplinary conference
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14
Q

Factors making RP sarcoma unresectable

A
  1. Involvement of major vascular structures
  2. Involvement of root of mesentery
  3. Involvement of spine
  4. Peritoneal implants
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15
Q

Treatment for RP sarcoma

A

Place ureteral stents

Resection to negative margins with en bloc resection of involveed structures.

Re-resection if recurrence

No role for neoadjuvant or adjuvant chemotherapy.

No role for lymphadenectomy

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16
Q

Factor that promotes angiogenesis in wound healing

A

Hypoxia inducible factor 1

17
Q

Collagen deposition peaks on this day of wound healing

A

21 days

18
Q

Cytokiens in early phase of wound healing

A

IL-1, IL-6, IL-8, TNF alpha

19
Q

Wound classificaiton and risk of wound infection

A

Clean 1-3%

Clean contaminated 5-8%

contaminated 20-25%

dirty 30-40%

20
Q

Raised, nodular, slow growing mass usually on trunk (and diagnosis and treatment)

A

Dermatofibrosarcoma protuberans (core needle, excision with 4 cm margins)

21
Q

CK-20 positive and TTF-1 negative

CK-20 positive and TTF-1 positige

A

Merkel cell carcinoma

small cell carcinoma of lung

22
Q

Most common location of epidermoid cyst (incorrectly call sebaceous cyst)

A

face (then trunk, neck)

23
Q

located below the sartorius fascia

A

lateral cutaneous femoral nerve

24
Q

characteristic histology of DFSP

A

finger projections

25
Q

Subclassifications of nonclostridial NSTI

A

Type I: polymicrobial

Type II: monomicrobial (GAS, SA)

Type III: Marine (vibrio)

Type IV: fungal (candida)

26
Q

More common: eye melanoma or anal melanoma

A

eye

27
Q

4 most common types of melanoma

A

Oral Boards (23 decks)

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